BREAST CARE AND EXPRESSING MILK

If your baby cannot breastfeed now and you plan to breastfeed later, it is important to care for your breasts. This means you must make sure the milk is expressed (removed) from your breasts every day at least 6 times a day. This prevents breast engorgement (swollen breasts) and ensures that milk will continue to be produced. Caring for your breasts will help keep you comfortable and will help to make sure there is milk for your baby.

HOW THE BREASTS PRODUCE MILK
The breasts are made up of milk-producing glands, tubes called "ducts," milk storage areas called "sinuses," and fatty tissue. The glands produce the milk. When the baby sucks, the milk flows through the sinuses and ducts to the nipple openings.

HOW TO CARE FOR YOUR BREASTS
- Wash your breasts with clear, warm water before expressing the milk. Do not use soap because soap removes the natural oils and may cause the nipples to crack. o Wear loose-fitting clothing to prevent binding. Picture 1 o Wear a nursing bra 24 hours a day (even to bed) to give Breastfeeding your support. A nursing bra allows you to uncover the breasts baby caIn be a special time for without removing the bra. both of you. - Keep nursing pads (without plastic backing) or clean, large, folded handkerchiefs inside your bra to soak up drops of milk that may leak between feedings or expressions. The pads help to keep the nipples dry. Change pads when they become wet. - Allow the nipples to be exposed to the air when possible (by leaving nursing flaps open), especially right after breastfeeding. This will help prevent cracking. - It is not necessary to wash your breasts after breastfeeding or expressing milk. Just let the breast milk dry on your breasts.

BREAST ENGORGEMENT
- Breast engorgement sometimes occurs when milk builds up in the breasts. Gentle massaging may help open the ducts and let the milk flow. - A warm shower or warm packs placed on the breasts will stimulate the milk to leak out and relieve the swelling. - A bra that is too tight can cut off circulation and cause the ducts to become plugged. Loosen your bra if it is too tight. - If you have severe engorgement, call your doctor or a lactation specialist.

WHEN TO EXPRESS THE MILK

Express the milk as often as your baby would be nursing if you were breastfeeding him (every 2 to 3 hours while awake). Also express milk if you awaken during the night. HH-IV-61R 3/82, Revised 11/94 Helping Hand Program Copyright 1994,1982, Children's Hospital, Inc., Columbus, Ohio. Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information contained in this Helping Hand. Ross Pediatrics, Abbott Laboratories is not responsible for any consequences resulting from the use or misuse of the information contained in this Helping Hand. FV102 Q-0WAW HOSPITAL

HOW TO EXPRESS THE MILK
Milk can be expressed with your hands (manual expression), with an electric breast pump, or with a battery-powered or hand-operated breast pump that can be purchased at a pharmacy. It takes practice and time to learn to express milk by any of these methods. Do not become discouraged if you have trouble at first. It is easier to express milk if you are relaxed. Mothers who need to express milk for several weeks may wish to use an electric pump.

1. Wash your hands thoroughly with soap and water.

2. Wash your breasts with clear, warm water.

3. Place the shield of the pump over the nipple area. Make sure there is complete contact with the skin around the rim of the shield.

4. Follow the directions for the specific pump you are using.

5. Repeat on the other breast.

6. Wash the collection parts in soapy water and rinse thoroughly after use.

Hand (Manual) Expression:

1. Wash your hands thoroughly with soap and water.

2. Wash your breasts with clear, warm water. Dry.

3. Place your thumb on top and your forefinger under the nipple.

4. Gently push your finger and thumb back toward your chest to grasp behind the milk sinuses. (Sinuses are the milk storage areas behind the nipple.)

5. Squeeze gently in a "milking" motion to remove the milk that has collected in the sinuses.

6. Repeat the procedure, changing the position of your grasp on the breast so that all sinuses are drained. Repeat on the other breast.

7. Express the milk into a clean container. Some women prefer to use a cup or bowl.

CARE OF THE MILK AND THE EQUIPMENT
1. Pour the milk into sterile containers.

2. Label the milk container with your baby's name, and the date and time of the collection of milk. 3. Store the milk as follows:

3. If you are using pumping equipment, rinse the equipment right after each pumping and wash it in hot soapy water. Rinse thoroughly and store in a clean area. Once a day, sterilize the equipment by washing it in a dishwasher. Clean equipment is essential to providing your baby with a safe supply of your milk.

WHEN TO CALL THE DOCTOR
Call your doctor (phone) if any of the following occurs: o If your breasts stay swollen or painfully engorged after expressing milk several times. o If your breasts feel hot when you touch them. o If you develop a fever.